Previous studies have hinted at an increased risk of perinatal complications in pregnant women who take fluoxetine. Kulin and colleagues evaluated pregnancy outcomes in women who received selective serotonin reup-take inhibitors (SSRIs) during pregnancy.
Women who contacted the Teratology Information Service about exposure to fluvoxamine, paroxetine or sertraline during pregnancy were included in this prospective, controlled cohort study. These patients were matched with randomly selected women who received counseling but were determined to have been exposed only to nonteratogenic substances. The SSRI dosage and the length of treatment were determined, and the women were contacted about nine months after their delivery to determine the outcome of the pregnancy. Rates of major malformations (anomalies having significant medical or social consequences) were determined.
Of the 267 women included in the study, 147 used sertraline, 97 used paroxetine and 26 took fluvoxamine. The SSRI was used throughout the pregnancy by 49 women. The rates of spontaneous and elective abortion, stillbirth and major malformations were not significantly different between the SSRI and the control groups. Neonates exposed to SSRIs had a relative risk of major malformations of 1.06. Pregnancy outcomes did not differ between women who took the SSRI for only the first trimester and those who took it for the entire pregnancy.
The authors conclude that SSRIs used during pregnancy do not increase teratogenic risk when used in recommended dosages.